8 - Understanding Self-Report of Sexual Abuse in an Initial Clinical Interview

Abstract

This chapter focuses on understanding self-report of sexual abuse in an initial interview. The limitations inherent in the information obtained are reviewed in light of additional challenges understanding sexual abuse. These are pointed, but not atypical, examples of the limitations of all information gathered in mental health services. All assessment information simultaneously serves a therapeutic function (and vice versa); the interplay between these is explored. Since sexual abuse history is typically embedded in the symptoms it generates, effectively managing such symptoms is the necessary initial strategy in working with sexual abuse. A goal-oriented, directive approach is offered with justification for its recommended use. It may appear in this approach that more preparation for addressing sexual abuse clinically than actual resolution has occurred. In fact, such “preparation” constitutes much of the actual clinical work and parallels the ways in which sexual abuse affects individual patterns of vulnerability and resiliency.